​Pathology - Celiac Sprue

​Pathology - Celiac Sprue
Autoimmune reaction to gluten found in wheat, oat, rye, and barley.
More prevalent in individuals of northern European ancestry and linked to HLA-DR3 and HLA-DQw2.

Pathology 
Gross: Diminishing and wasting away of tiny intestinal mucosal villi
Microscopic findings include elevated levels of lymphocytes and plasma cells in the lamina propria, as well as absence of the brush boundary. 

Clinical Manifestations
Symptoms may appear in infancy as growth retardation and failure to thrive, or in young adulthood as malabsorption symptoms. May exhibit steatorrhea characterized by pale, bulky, and frothy stools. malodorous feces. Abdominal bloating. Weight reduction. Dermatitis herpetiformis is a condition characterized by symmetric, recurrent, itchy, subepidermal blisters that typically appear on the extensor surfaces of the limbs, trunk, scalp, and neck. 10% to 15% of patients will develop enteropathy-type T-cell lymphoma.
Laboratory results show abnormal D-xylose test, presence of antigliadin, antiendomysial, and anti-TTG antibodies.

Therapy 
Following a gluten-free diet, using dapsone for dermatitis herpetiformis, and taking vitamin B2 and calcium supplements.
Tropical sprue is a malabsorption syndrome induced by the proliferation of enterotoxigenic organisms in tropical regions and is treated with broad-spectrum antibiotics.
Whipple illness is a rare multisystemic infection caused by a PAS-positive actinomycete. Tropheryma whippelii.
It manifests as malabsorption syndrome and arthralgias.
Involvement of the central nervous system, heart, and eyes.